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MRI showed multiple retroperitoneal lymphadenopathies, bulky nodular adrenal lesions and bilateral iliac lytic lesions. Hypocortisolism was detected and treated with steroids. A CT-guided biopsy to the psoas mass and lytic lesions identified infiltration of non-small lung carcinoma. The patient died within days. Psoas metastases and adrenal insufficiency as initial manifestations of malignancy are rare and can be misdiagnosed, particularly in the absence of a known primary tumour.<\/jats:p>","DOI":"10.1136\/bcr-2014-204496","type":"journal-article","created":{"date-parts":[[2015,6,10]],"date-time":"2015-06-10T17:53:48Z","timestamp":1433958828000},"page":"bcr2014204496","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Just another abdominal pain? 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